Amongst female cancer patients there is a high incidence of ovarian cancer and this is associated with high mortality (Modugno et al., Am J of Obstetrics and Gynecology 191:733-740, 2004). It is the fifth most common cancer in women, following breast, bowel, lung and uterine cancers. It is called a silent killer because it is asymptomatic until it reaches the late stages (Chauhan et al., J of Ovarian Research 2:2215, 2009). Early diagnosis of ovarian cancer is difficult because the first symptoms are non-localized mild pain, but the symptoms of ovarian malignancies become clearer in the late stages, and include loss of appetite and weight, strong pain in the back and pelvis associated with vaginal bleeding after menopause, frequent urination, constipation or diarrhea and bloating in the abdomen (American Cancer Society, 2013).
The early detection of ovarian malignancies represents a so far unmet need. The presently used tumor associated biomarkers, for example the relatively unspecific tumor marker CA-125, all fail to detect ovarian malignancies at an early stage.
Therefore, there is a pressing need to develop a non-invasive clinical test for early diagnosis to discover ovarian malignancies at an early stage when treatment is effective and the prognosis much better then in later stages of ovarian cancer.